Expansion of PrEP and PEP services in China

Despite the progress made in HIV control in China, an average of 15 new HIV infections were identified each hour in 2021, reflecting a cumulative number of 1·14 million cases by the end of the year. More than 97% of the newly identified HIV infections occurred through sexual transmission, with male-to-male sexual contacts accounting for over 25%. 1 Xu J Tang W Zhang F Shang H PrEP in China: choices are ahead. Lancet HIV. 2020; 7: e155-e157 Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar This infection rate is even worse in developed provinces, where men who have sex with men (MSM) account for more than 50% of new HIV infections. Since 2019, China has started to promote pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for HIV prevention by implementing several demonstration projects, approving emtricitabine and tenofovir disoproxil (Truvada, Gilead, Foster City, CA) for PrEP, and issuing technical guidelines for PrEP and PEP. However, only 20% of Chinese MSM have a good knowledge of PrEP and PEP, 2 Li H Wei R Piqueiras E et al. HIV non-occupational postexposure prophylaxis (nPEP) usage among five key populations in China. Sex Transm Infect. 2021; 97: 411-413 Crossref PubMed Scopus (3) Google Scholar and less than 1% have started taking PrEP. 3 Zhang L Peng P Wu Y et al. Modelling the epidemiological impact and cost-effectiveness of PrEP for HIV transmission in MSM in China. AIDS Behav. 2019; 23: 523-533 Crossref PubMed Scopus (23) Google Scholar Many challenges from health-care providers, the health-care system, and public promotion have limited the scale-up of PrEP and PEP in China.